Combination radiographic apparatus

ABSTRACT

A combination radiographic apparatus for taking panoramic, intra oral, occlusal and cephalometric and other types of radiographs of the head, jawbone and teeth, said apparatus comprising a rotating anode tube X-ray source, a film holder assembly and means for interchanging the pivot point of rotation relative to the subject being X-rayed. Pivot shifting means are also provided for shifting the pivot point by shifting the apparatus relative to the subject; the subject remaining stationary or shifting a free standing or sitting subject to predetermined positions with the apparatus remaining stationary. The X-ray source and film holder assembly are disposed opposite each other, the subject matter to be X-rayed being placed directly in line between the source and the film.

United States Patent Moss [ June 27, 1972 [541 COMBINATION RADIOGRAPHIC APPARATUS [72] Inventor: Merton Moss, 6701 N. Keeler, Lincolnwood, 111. 60646 [22] Filed: April 27,1970

[21] Appl. No.: 32,217

3,514,606 5/1970 Rabey ..250/65 3,521,057 7/1970 Morlan ..250/50 Primary Examiner-William F. Lindquist Attorney-Irving Faber [57] ABSTRACT A combination radiographic apparatus for taking panoramic, intra oral, occlusal and cephalometric and other types of radiographs of the head, jawbone and teeth, said apparatus comprising a rotating anode tube X-ray source, a film holder assembly and means for interchanging the pivot point of rotation relative to the subject being X-rayed. Pivot shifting means are also provided for shifting the pivot point by shifting the apparatus relative to the subject; the subject remaining stationary or shifting a free standing or sitting subject to predetermined positions with the apparatus remaining stationary, The X-ray source and film holder assembly are disposed opposite each other, the subject matter to be X-rayed being placed directly in line between the source and the film.

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COMBINATION RADIOGRAPIIIC APPARATUS BACKGROUND OF INVENTION The present invention relates to a new apparatus for taking panoramic, intra oral and cephalometric type radiographs of the head, jawbone and teeth. In particular, the invention is directed to a single structure apparatus having a rotating anode type X-ray tube coupled to means for taking panoramic intra oral cephalometric radiographs.

I-leretofore, separate X-ray units, each with its own generating source, were necessary to produce panoramic intra oral and cephalometric type radiographs. Panoramic type X-ray devices for taking pictures of the jaw and teeth are well known in the art. One such type device is where the film moves behind a slit around and somewhat close to the front and sides of the face and in line with a source of radiographic radiation with both the source and the film pivoting about a point positioned on a line between the film directly behind the slit and the source of radiation; where the source and structure are fixed to just one pivot point; a change in pivot point is occasioned by shifting a chair in which the subject is seated.

Another type of such panaramic device is one in which the patient remains fixed; however, the radiation source changes pivot points as it rotates about the patients head. The pivot points and therefore the resulting pivot pattern as the source moves around the patients head are determined; said pivot points and resulting pivot pattern being non-interchangeable with other pivot patterns. Various pivot patterns may be necessary since the pattern of bone structure may change from one subject to another or from one group of subjects to another group of subjects.

Neither of the two aforesaid panoramic type devices are suitable for taking intra oral films, nor do they provide for taking occlusal dental films, nor do they provide for taking cephalograms.

As stated before the existing panoramic type devices either use a single pivot or a multiple pivot arrangement; and neither of said devices provides means to interchange from the single pivot point to a multiple pivot point or from one multiple pivot pattern to another multiple pivot pattern.

cephalometric type radiographic devices are also well known in the radiographic art and are used for taking intra oral and occlusal radiographs. However, they cannot take panoramic type radiographs, and require their own generating means.

Panoramic and cephalometric type radiographic devices are necessary diagnostic tools for the surgeon, dentist, orthodonist, researcher, etc. However, because of space requirements as well as cost it is generally not feasible to have both type of devices in an office. Further, there are no panoramic type radiographic devices existing which offer the doctor, researcher, etc., the versatility of interchanging the number of pivot points and pivot patterns.

The present invention not only combines, in one structure, the ability to take both panoramic and cephalometric radiographs, but has means for interchanging the pivot points and thus pivot pattern.

SUMMARY OF INVENTION The present invention incorporates, in one structure, an apparatus which can take panoramic and cephalometric radiographs as well as intra oral and occlusal radiographs. A rotating anode tube is used for the panoramic radiographs; said X- ray tube having means to be locked in place when intra oral, occlusal, and cephalometric radiographs are desired.

A principal object of the invention is to provide a single structure for obtaining panographic, intra oral, occlusal and cephalometric radiographs.

Another object of the invention is to provide a device for taking both panoramic, intra oral, occlusal and cephalometric radiographs having a single source of X-ray radiation.

Still another object of this invention is to provide an improved radiograph by mounting a fine focus rotating anode type of X-ray tube in the structure instead of the stationary anode, self-contained type.

Still a further object of this invention is to provide a radiographic device for taking panoramic radiographs and having means to interchange the number of pivot points and pivot patterns in relation to the radiation source which passes around the subjects head.

Another object of the invention is to provide means for changing the pivot point for panoramic radiographs by moving the machine in relation to the seated subject to any one of a preselected shift distance.

Still a further object is to be able to shift the free standing or seated subject to predetermined positions.

IN THE DRAWINGS The invention can best be understood by referring to the accompanying drawings.

FIG. 1 is a front elevational view of the apparatus embodied by this invention.

FIG. 2 is a perspective view illustrating the means of synchronizing the movement of the X-ray source with the film assembly, and the interchangeable means for changing pivot patterns.

FIG. 3 is a perspective view in part, of the present invention illustrating the relationship between the X-ray source, the su bject, and the film.

FIG. 4 is a top plan view illustrating the synchronization between the X-ray source and the film.

FIG. 5A illustrates an interchangeable guide plate for a single pivot point.

FIG. 53 illustrates an interchangeable bracket for a single pivot point.

FIG. 5C illustrates an interchangeable guide plate for multiple pivot points.

FIG. 5C illustrates an interchangeable bracket for multiple pivot points.

DESCRIPTION OF PREFERRED EMBODIMENT FIG. 1 illustrates the combination radiographic apparatus embodied by this invention and is indicated generally by the reference character 10. The apparatus 10 has a base member 12 coupled to an upright supporting member 14. A source of X-ray radiation 16, a film holder assembly 18, and rotating means 20 are coupled to the upright member 14 by means of a guide support 22. The guide support 22 is moveable upon the upright member 14 by means well known in the art. A head positioner 24 is coupled to a horizontal support bar 26 which may be continuous or hinged and which is also coupled to guide support 22. A hinge 27 is positioned at some point on the horizontal support bar 26 to enable the head positioner to be rotated to any desirable position out of the way or folded back upon the support bar 26.

The head positioner 24 is similar to the head positioner used on the CEPI-IALOMETRIX as manufactured by the Universal X-ray Products, Inc., of Chicago, Illinois. The head positioner 24 is comprised of a pair of ear posts 28 positioned opposite one another and separated by a distance suitable for positioning a human head therebetween. The pair of ear posts 28 are coupled to a swivel cassette holder 30 which also has coupled thereto a nasion rest assembly 32. The swivel cassette holder 30 is coupled to the horizontal support bar 26. A micro lock knob 34 assures consistent accurate alignment of the ear posts 28. An adjustable cassette holder 36 is coupled to the swivel cassette holder 30 and is positioned adjacent one of the pair of ear posts 28.

A pivot shifting system 40 is comprised of a lever arm 41 having opposite ends 41a and 41b. A slot 42 is machined in arm 41 adjacent end 41a. A guide shift bar 43 having opposite ends 42a and 43b is coupled to the lever arm 41 and the upright member 14; end 430 thereof being connected to slot 42 by slidable means 44 well known in the an and the end 43b being coupled to the upright 14 by support block 45 and connected thereto by means well known in the art. The support block 45 is affixed to the upright 14. It is understood that the end 43b of the guide shift bar 43 may be connected directly to the upright 14.

- A lever arm support bracket 46 is positioned within a housing 47, which is illustrated without it cover, to support the lever arm 41. The lever arm support bracket 46 is connected to the base 12. Electrical circuitry, not shown, could also be installed within the housing 47 to coordinate the positioning of the upright member 14 and the movement of the X-ray source 16; said circuitry being common control circuitry well known in the art.

The degree of movement of the upright member 14 along the base 12 is controlled by the position of end 43a within the slot 42. Generally there are three set positions; the first being when lever 41 is in one extreme position; the second being when the lever 41 is in the opposite extreme position; and the third being a center position there between. It is understood that any intermediate position between the opposite ends may be set. Electrical control circuitry can be incorporated to position the upright member 14 along the base 12, said circuitry being positioned within houseing 47, and not shown. A handle grip 48 is positioned at end 41b of the lever arm 41, having means 49 to energize electrical control circuit for engaging the pivot shifting means.

The pivot shifting system 40 heretofore described enables the taking of panoramic radiographs by moving the apparatus 10 in relation to the seated or standing'subject to any one of a preselected shift distance. In this instance the X-ray source 16 rotates about a fixed pivot point, however, it may also be operated about a multiple pivot point.

The rotating means 20 is best illustrated in FIGS. 2 and 3 and is comprised of a circular platform 50, a motor assembly 51, a guide plate 52 and a pivot bracket support structure 54.

The platform 50 is secured to the guide support 22 by means well known in the art; said platform having an opening 56 centrally disposed therein. Preferably the opening 56 is of a circular configuration; however, other geometric configurations would also be suitable. The guide plate 52 is positioned on platform 50 over the opening 56. If a single pivot point relative to the patients head is desired, the guide plate has a single aperture positioned'therein as illustrated in FIG. A. However, if multiple pivot points are desired a specific configuration is out within the guide plate 52 to obtain the desired number of pivot points, one of said configurations being illustrated in FIG. 5C.

The pivot bracket support structure 54 is comprised of parallel arms 58, 58', said members defining a space therebetween and being of sufficient length to extend across the diameter of the platform 50. A winged pivot bracket 60 is positioned between the parallel arms 58,58, said bracket having wing elements 62',62" and a base element 64 illustrated in FIGS. 58 and 5D.

The wing elements 62',62" are respectively attached to parallel arms 58,58 by wing nuts 66, the wing nuts 66 engaging a threaded stud 67 that extends vertically from said parallel arms. However, other suitable means for attaching the winged bracket 60 to the parallel arms 58,58 may be used. The base element 64 is positioned within the space defined by the parallel arms 58,58 and engages the guide plate 52 by means of cam follower pivots 68,68, and 68".

The cam follower pivots 68,68 and 68" are mounted on a pivot mounting bar 69, as best illustrated in FIG. 5D, which is connected to the base element 64 of the winged bracket 60. One end of the cam follower pivots 68,68 and 68" extend through the base element 64, the other end of said pivots extending through the pivot mounting bar 69 a sufficient distance so that said cam follower pivots will engage a guide plate 520 illustrated in FIG. 5C. The guide plate 52a is positioned over the platform opening 56 and coupled to the platform 50 by means well known in the art. The guide plate 52a illustrated in FIG. 5C represents a pivot pattern having three pivot points.

The pivot points change as the support structure 54 to which the X-ray source 16 is coupled rotates about the platform 50; the pivots 68,68 and 68" engaging the guide plate 52a.

Various pivot patterns may be necessary because of the bone structure of different subjects. A different guide plate 52 can be used to meet the specific requirements of a particular bone structure of structures of a subject or a group of subjects; thereby enabling one to obtain clear, concise radiographs of a subject no matter how far from a norm his bone structure is.

FIGS. 5A and 58 respectively represent the guide plate 52 and winged bracket 60 for a unitary pivot point about the head of a subject. The cam follower pivot 68 extends through the base element 64 and when the bracket 60 is connected to the pivot bracket support structure 54, as hereinabove described, the cam follower pivot extends into the guide plate 52, which for a unitary pivot point would consist of a single aperture through said plate 52. The pivot mounting bar 69 is not necessary for the unitary pivot point configuration.

The guide plates 52 may be easily changed to accommodate the particular subject being radiographed. To change the guide plate the winged bracket 60 is removed from the pivot bracket support structure 54 by removing the wing nuts 66 connecting the winged bracket 60 to the pivot bracket support structure 54. The winged bracket 60 lifts ofi' of the support structure 54, the cam follower pivot 68 extending from the winged bracket becoming disengaged from the guide plate 52. The guide plate 52 has a plurality of securing aperatures 70 spaced so as to engage a plurality of studs 72 extending vertically from the platform 50. The guide plate 52 is easily positioned over or removed from the studs 72. It is understood that there are various other methods known in the art which would be suitable for engaging and disengaging the plate 52 to or from the platform 50.

To insert a new pivot pattern or guide plate 52, the existing one is then lifted off the holding studs and the new one placed thereon. The winged bracket 60 having pivots 68, 68', 68" extending therefrom for the new pattern is placed in position over the plate and the wing nuts 66 secure it to the support structure 54. It is therefore possible to easily change from one to one of several pivot patterns having one or several pivot points as the X-ray source rotates about the head of the subject.

The motor assembly 51 is attached to the pivot bracket support structure 54 by means well known in the art. A first friction wheel 78 is interposed between the motor assembly 51 and the platform 50 and is directly coupled to the motor assembly '51. The X-ray source 16 is coupled to one end of the parallel arms 58,58 and the film holder assembly is coupled to the opposite end thereof. A second friction wheel 79 is interposed between the film holder assembly 18 and platform 50.

The motor assembly 51 drives the guide plate support structure 54 around the circular platform 50. The film not shown within the film holder assembly 18 moves within the assembly 18; said movement being synchronized to the rotation of the film assembly unit 18 and the X-ray source 16 as they traverse about the circumference of the platform 50. The aforesaid synchronization occurs by means of a bar gear arrangement 80, best illustrated in FIG. 4. Motion is imparted to a drive gear 82 by means of the friction wheel 79, to a positive drive shaft 84 to which said gear is coupled. The friction wheel imparts motion to the shaft 84 as the motor assembly 51 drives the pivot bracket support structure 54; the friction wheel engaging the circular platform 50 so that motion is imparted to it as the pivot bracket support structure 54 rotates. The positive drive shaft 84 is coupled to the pivot bracket support structure 54 by means of a gear support plate 86. A second drive gear 88 is coupled to the film holder assembly 18 and imparts motion to a film support structure 90 by means of a shaft 92. A bar gear rack 94 engages the drive gears 82 and 88 with positive engagement therewith being maintained by a pressure roller 96. The film support structure 90 rotates within the film holder assembly as the motor assembly 51 drives the X-ray source 16 and film holder assembly about the circumference of the platform 50.

The guide support assembly 22 has coupled thereto a head positioning assembly 98. The head positioning assembly 98 is comprised of a forehead member 100 and an adjustable chin member 102 and a centering or lateral shifi distance assembly 104. The forehead member 100 is a forehead positioning device which adjusts to any position at right angles to the lateral shift assembly 104. The centering or lateral shift consists of a lateral shift support 106 positioned on each side of the head positioning device 98. A lateral shift pad 108 is positioned on each of the lateral shift support members 106. A screw assembly 110 having a knob 111 enable the lateral shift support members 106 to be laterally moved relative to one another to position the subjects head as best illustrated in FIG. 3. The lateral shift assembly 104 enables the subject to laterally move his head, thereby changing the pivot point rela tive to the subject as the X-ray source 16 rotates about the subject's head; this being done without moving the machine by means of the pivot shifting system 40 or by physically shifting the subject as is the common practice today.

The X-ray source 16 is a rotating anode type X-ray tube having a hinged lead shutter 112 over an emission aperture 1 13 of the X-ray source 16. The lead shutter 112 has a slit 114 enabling a source of X-ray to be directed from said X-ray source 16.

In operation, to take a panoramic radiograph of a patient's head 115, illustrated in FIG. 3, the doctor, researcher, etc., determines which one of several pivot patterns would give him the best results, i.e., a guide plate 52 having a single pivot point as illustrated in FIG. 5A or of a multiple pivot configuration as illustrated in FIG. 5C. It is understood that the single pivot point guide plate would be used if the shifting of the pivot point is to be effectuated by the pivot shifting system 40 for which the subject remains stationary and the vertical upright member 14 shifts, or by shifting the sitting or standing subject to a selected position of supports 106 of the lateral shift assembly 104. It is readily seen that the combination radiographic apparatus 10 can take a panoramic radiograph utilizing several methods of changing pivot points of the X-ray source 16 relative to the subjects head as the X-ray source 16 rotates about the subject. The changing pivot points are necessary since the bone structure of the head is not the same for all persons. The existing apparatus have only one means for changing pivot points and these means are not interchangeable with any other means for changing pivot points. The subjects head as illustrated in FIG. 3 is positioned within the head positioning assembly 98 by placing his chin to the adjustable chain member 102. The lateral shifting assembly 104 is adjusted so that the lateral shift supports 106 are positioned the proper distance apart for the subjects head to move from shift support to the other. The lateral shift assembly 104 is also used to center the subject's head by bringing shift supports 106 together until they touch both sides of the subjects head; this centering is used when using a multiple pivot assembly. However, using a multiple pivot assembly does not always require shifting the subject in relation to the pivot assembly. The X-ray source 16 and the motor assembly 51 are energized by means well known in the art, but not illustrated. The hinged lead shutter l 12 is positioned over the emission aperture 114. A film sheet, not shown, is positioned within the film support structure 90.

A motor locking means 116 is coupled to the motor assembly 51 and either frictionally engage or disengage the first friction wheel 78 against the platform 50. When the friction wheel 78 is engaged against the platform 50, the guide plate support structure 54, having coupled thereto the X-ray source 16 and the film holder assembly 18, rotates about the patients head taking a panographic radiograph of the desired area. The film within the film support structure 90 moves in synchronization with the rotation of the guide plate support structure, thereby enabling the panographic radiograph to be taken.

A forward limit switch 118 and a reverse limit switch 120 stop further movement of the pivot bracket support structure 54 as it approaches the guide support assembly 22.

A pair of grips 122 are positioned on the guide support assembly 22 to enable one to easily grip the assembly 22 and adjust its height to accommodate the patient. A pair of support cables 124 are attached to weights, not shown, to balance the guide assembly 22, this being well known in the art.

The foregoing description relates to taking panoramic radiographs having interchangeable means to change the number of pivot points as well as shifting the pivot point by shifting the apparatus relative to the subject as well as shifting the subject relative; the subject being either in the standing or sitting position.

Intro oral, occlusal, cephalometric and other types of radiographs of the head, jawbone, teeth, as well as other parts of the body can be taken by the apparatus 10. A collimator or cone as it is sometimes referred to is coupled to the X-ray source 16 by raising the hinged lead shutter 112. A lock pin 132 enables the X-ray source 16 to freely rotate about its axis 134. The X-ray source 16 with the collimator 130 coupled thereto is in a direct line with the head positioner 24, the subject being positioned therebetween and adjacent the collimator 130, for taking intra oral radiographs; the film being positioned within the patients mouth adjacent the area to be X- rayed.

The subjects head is positioned with the head positioner 24 for taking cephalometrix radiographs; the X-ray source 16 transmitting X-rays through the collimator 130 to the area of the head desired to be radiographed. The film, not illustrated, is held in the cassette holder 36. The ear posts 28 and the nassion rest assembly 32 are adjusted to the subject's head. The collimator 130 has means for locking into a predetermined position with adjustments, not illustrated, for shifting prealignment with the head positioner 24; and once so adjusted it is set in position, the subject being able to be removed from the head positioner 24 and return thereto without resetting the alignment.

Occlusal radiographs are obtained by positioning the subject, as required, between the X-ray source 16 and the head positioner 24. The area to be X-rayed is positioned in line with the collimator.

A variety of X-rays other than those of the head, jawbone and teeth can be taken with the apparatus 10; e.g., and chest X-ray. A chest X-ray can be taken by lifting the head positioner 24 about the hinge 27, thereby removing the head positioner 24 entirely out of line from the X-rays being transmitted through the collimator 130. The lifting of the head positioner 130 out of line of the X-ray source enables a patient to be positioned, that is any part thereof, between the film, not shown, and said X-ray source.

FIG. 4 illustrates the X-ray source 16 in two positions. In the first position the lock pin 132 is locked into position with the pivot bracket support structure 54 for taking panoramic radiographs; the X-ray source 16 rotating about the platform 50 by means of the motor assembly 51. The second position is illus trated with the X-ray source 16 coupled to the collimator 130. Each of the reference characters have a prime designation added thereto.

Electrical interlocks and control circuitry, which are very well known in the art, are employed so that the apparatus 10 can only operate in the mode selected; i.e., for the taking of panographic, intra-oral, cephalometrix, etc.

A support member 136 is attached to the apparatus 10 to support the structure against a wall or other supportable entity. A counter balance, not shown, is employed to adjust the guide support assembly 22 in a vertical direction in line with the upright member 14. The pair of cables 124 connect the guide support assembly 22 to the counter balance over a pair of pulley rollers 140.

A pair of guide rails 142 is integral with the upright member 14 enabling the guide assembly 22 to move in a vertical direction along said upright member 14 for individual patient adjustment thereof.

It is believed that the invention has been described in sufficient detail to enable the skilled artisan to understand and practice the same. Minor variations in size, proprtion, and arrangement of parts thereof may be made without departing from the spirit and scope of the invention.

What is desired to be secured by Letters Patent of the United States is:

l. A combination radiographic apparatus comprising:

a base member;

an upright member coupled to the base member;

an X-ray source;

a film holder assembly coupled to the X-ray source and disposed opposite thereof enabling a subject to be positioned therebetween, said X-ray source and film holder assembly being coupled to the upright member;

means for rotating the X-ray source and film holder as sembly about the subject defining a pivot point of rotation thereabout enabling the taking of panoramic radiographs;

a guide support assembly slidably mounted to the upright member;

a platform coupled to the guide support assembly;

a pivot bracket support structure interposed between and coupled to the X-ray source and film holder assembly, and coupled to said platform; and

interchangeable means coupled to said pivot bracket support structure to enable the pivot point of rotation of the X-ray source and film holder assembly about a subject to be altered, said interchangeable means being coupled to said pivot bracket support structure.

2. A combination radiographic apparatus as defined in claim 1 further comprising:

alignment means coupled to said pivot support structure and X-ray source enabling the X-ray source to freely rotate about its axis for taking intra-oral, occlusal, and cephalometric radiographs.

3. A combination radiographic apparatus as defined in claim 2 wherein said means for enabling the X-ray source and film holder assembly to rotate about the subject, comprises:

a motor assembly coupled to said pivot bracket support structure, said motor assembly having a friction wheel engaging said platform.

4. A combination radiographic apparatus as defined in claim 3 wherein said interchangeable means comprises:

a winged pivot bracket having a pair of winged elements and a base element, said winged elements being connected to the pivot bracket support structure; and

a guide plate interposed between said pivot bracket support structure and said platform, and opposite said winged pivot bracket, said guide plate having a predetermined pattern therein.

5. A combination radiographic apparatus as defined in claim 4 wherein said interchangeable means includes:

a cam follower pivot, said cam follower pivot being affixed to the winged pivot bracket and being of a suitable length for engaging said guide plate, the cam follower moving within the guide plate defining a pivot point of rotation of the X-ray source and film holder assembly about the subject as the X-ray source and film holder assembly rotate.

6. A combination radiographic apparatus as defined in claim 5 wherein said pivot bracket support structure has means for engaging said winged pivot bracket thereto.

7. A combination radiographic apparatus as defined in claim 6 wherein said platform is a circular configuration having an aperture therein, and where said guide plate has means for engaging said platform over said aperture.

8. A combination radiographic apparatus as defined in claim 7 wherein translating means are provided to synchronize the movement of film within the film holder assembly with rotation of the X-ray source and the film holder assembly, a continuous film strip being exposed to X-ray radiation as the X-ray source and the film holder assembly traverse the subject.

9. A combination radiographic apparatus as defined in claim 1 said apparatus further comprising:

pivot shifting means for shifting the upright member on the base member relative to a subject enabling the subject to remain stationary while the pivot point is shifted relative to said subject.

10. A combination radiographic apparatus as defined in claim 9 wherein said pivot shifting means comprises:

a guide shift bar having a first and second end;

a lever arm having a first end and an opposite end;

a slot positioned in said lever arm adjacent said opposite end thereof, wherein said first end of the guide shifi bar is coupled to said upright member and the second end thereof is coupled to said slot, said lever arm being coupled to the base member by a support bracket.

11. A combination radiographic apparatus as defined in claim 1 wherein said apparatus further comprises:

a head positioning assembly coupled to the guide support assembly.

12. A combination radiographic apparatus as defined in claim 11 wherein said head positioning assembly comprises:

a forehead member coupled to the guide support assembly;

an adjustable chin member;

a lateral shift distance assembly; and

a head mask coupled to said guide support assembly, said adjustable chin member and lateral shift distance assembly being coupled to said head mask.

13. A combination radiographic apparatus as defined in claim 2 wherein said apparatus further comprises:

a collimator coupled to the X-ray source for directing X-ray radiation from the X-ray source to the subject enabling said apparatus to take intra-oral radiographs, the X-ray source being aligned with the area to be radiographed by the alignment means.

14. A combination radiographic apparatus as defined in claim 2 wherein said apparatus includes means for taking cephalometric radiographs, said means comprising:

a head positioner;

a collimator coupled to said X-ray source; and

a hinged support bar having one end coupled to the upright member and its opposite end coupled to the head positioner, the subject being positioned within said head positioner, and the X-ray source being positioned a predetermined distance from the head positioner by the alignment means.

15. A combination radiographic apparatus as defined in claim 2 wherein said X-ray source is a rotating anode tube.

16. A combination radiographic apparatus as defined in claim 2 wherein said apparatus includes means for taking occlusal radiographs, said means comprising:

a head positioner;

a collimator coupled to said X-ray source; and

a hinged support bar having one end thereof coupled to the upright member and its opposite end coupled to the head positioner, the X-ray source being aligned with the head positioner by the alignment means, the subject being positioned between the X-ray source and the head positioner.

17. A combination radiographic apparatus for taking radiographs of a subjects head, teeth, jawbone and other parts of the subjects body, said apparatus comprising:

a base member;

an upright member coupled to the base member;

an X-ray source;

a film holder assembly coupled to the X-ray source and disposed opposite thereof enabling a subject to be positioned therebetween, said X-ray source and film holder assembly being coupled to the upright member;

means for enabling the X-ray source and film holder assembly to rotate about the subject and defining a pivot point of rotation thereabout enabling the taking of panoramic radiographs;

a guide support assembly slidably mounted to the upright member;

a platfonn coupled to the guide support assembly;

a pivot bracket support structure interposed between and coupled to the X-ray source and film holder assembly, and coupled to said platform;

interchangeable means coupled to said bracket support structure enabling the pivot point of rotation of the X-ray source about a subject to be altered; and

alignment means coupled to said pivot support structure and X-ray source enabling the X-ray source to freely rotate about its axis enabling the X-ray source to be aligned relative to the subject for taking intra-oral, occlusal and cephalometric radiographs.

18. A combination radiographic apparatus as defined in claim 17 wherein said X-ray source is a rotating anode tube.

19. A combination radiographic apparatus as defind in claim 18 wherein said means for rotating the X-ray source and the film holder assembly about a pivot point comprises:

a motor assembly coupled to the pivot bracket support structure.

20. A combination radiographic apparatus as defined in claim 19 wherein said means for rotating the X-ray source and the film holder assembly about a pivot point further includes:

a first friction wheel engaging said platform being coupled to said motor assembly;

a second friction wheel adjacent the film holder assembly,

said second friction wheel engaging the platform and coupled to said film holder assembly so that as the motor assembly drives the first friction wheel about the platform motion is imparted to the second friction wheel; and

means for disengaging the first friction wheel from the platform.

21. A combination radiograph apparatus as defined in claim 20 wherein the means for interchanging the pivot point of rotation of the X-ray source and film holder assembly relative to the subject, comprises:

a guide plate positioned between the platform and the pivot bracket support structure.

cam follower means coupled to the pivot bracket support structure for matingly engaging said guide plate.

22. A combination radiographic apparatus as described in claim 21 wherein said cam follower means comprises:

a winged pivot bracket.

23. A combination radiographic apparatus as defined in claim 22, said apparatus further comprising:

pivot shifting means for shifting the upright member on the base member relative to a subject, enabling the subject to remain stationary while the pivot point is shifted relative to said subject.

24. A combination radiographic apparatus as defined in claim 23 wherein said pivot shifting means comprises:

a guide shift bar having a first and second end;

a lever arm having a first end and an opposite end;

a slot positioned in said lever arm adjacent said opposite end thereof, wherein said first end of the guide shift bar is coupled to said upright member and the second end thereof is coupled to said slot, said lever arm being coupled to the base member by a support bracket.

25. A combination radiographic apparatus as defined in claim 24 wherein said apparatus further comprises:

a head positioning assembly coupled to the guide support assembly.

26. A combination radiographic apparatus as defined in claim 25 wherein said head positioning assembly comprises:

a forehead member coupled to the guide support assembly;

an adjustable chin member;

a lateral shift distance assembly; and

a head mask coupled to said guide support assembly, said adjustable chin member and lateral shift distance assembly being coupled to said head mask. 

1. A combination radiographic apparatus comprising: a base member; an upright member coupled to the base member; an X-ray source; a film holder assembly coupled to the X-ray source and disposed opposite thereof enabling a subject to be positioned therebetween, said X-ray source and film holder assembly being coupled to the upright member; means for rotating the X-ray source and film holder assembly about the subject defining a pivot point of rotation thereabout enabling the taking of panoramic radiographs; a guide support assembly slidably mounted to the upright member; a platform coupled to the guide support assembly; a pivot bracket support structure interposed between and coupled to the X-ray source and film holder assembly, and coupled to said platform; and interchangeable means coupled to said pivot bracket support structure to enable the pivot point of rotation of the X-ray source and film holder assembly about a subject to be altered, said interchangeable means being coupled to said pivot bracket support structure.
 2. A combination radiographic apparatus as defined in claim 1 further comprising: alignment means coupled to said pivot support structure and X-ray source enabling the X-ray source to freely rotate about its axis for taking intra-oral, occlusal, and cephalometric radiographs.
 3. A combination radiographic apparatus as defined in claim 2 wherein said means for enabling the X-ray source and film holder assembly to rotate about the subject, comprises: a motor assembly coupled to said pivot bracket support structure, said motor assembly having a friction wheel engaging said platform.
 4. A combination radiographic apparatus as defined in claim 3 wherein said interchangeable means comprises: a winged pivot bracket having a pair of winged elements and a base element, said winged elements being connected to the pivot bracket support structure; and a guide plate interposed between said pivot bracket support structure and said platform, and opposite said winged pivot bracket, said guide plate having a predetermined pattern therein.
 5. A combination radiographic apparatus as defined in claim 4 wherein said interchangeable means includes: a cam follower pivot, said cam follower pivot being affixed to the winged pivot bracket and being of a suitable length for engaging said guide plate, the cam follower moving within the guide plate defining a pivot point of rotation of the X-ray source and film holder assembly about the subject as the X-ray source and film holder assembly rotate.
 6. A combination radiographic apparatus as defined in claim 5 wherein said pivot bracket support structure has means for engaging said winged pivot bracket thereto.
 7. A combination radiographic apparatus as defined in claim 6 wherein said platform is a circular configuration having an aperture therein, and where said guide plate has means for engaging said platform over said aperture.
 8. A combination radiographic apparatus as defined in claim 7 wherein translating means are provided to synchronize the movement of film within the film holder assembly with rotation of the X-ray source and the film holder assembly, a continuous film strip being exposed to X-ray radiation as the X-ray source and the film holder assembly traverse the subject.
 9. A combination radiographic apparatus as defined in claim 1 said apparatus further comprising: pivot shifting means for shifting the upright member on the base member relative to a subject enabling the subject to remain stationary while the pivot point is shifted relative to said subject.
 10. A combination radiographic apparatus as defined in claim 9 wherein said pivot shifting means comprises: a guide shift bar having a first and second end; a lever arm having a first end and an opposite end; a slot positioned in said lever arm adjacent said opposite end thereof, wherein said first end of the guide shift bar is coupled to said upright member and the second end thereof is coupled to said slot, said lever arm being coupled to the base member by a support bracket.
 11. A combination radiographic apparatus as defined in claim 1 wherein said apparatus further comprises: a head positioning assembly coupled to the guide support assembly.
 12. A combination radiographic apparatus as defined in claim 11 wherein said head positioning assembly comprises: a forehead member coupled to the guide support assembly; an adjustable chin member; a lateral shift distance assembly; and a head mask coupled to said guide support assembly, said adjustable chin member and lateral shift distance assembly being coupled to said head mask.
 13. A combination radiographic apparatus as defined in claim 2 wherein said apparatus further comprises: a collimator coupled to the X-ray source for directing X-ray radiation from the X-ray source to the subject enabling said apparatus to take intra-oral radiographs, the X-ray source being aligned with the area to be radiographed by the alignment means.
 14. A combination radiographic apparatus as defined in claim 2 wherein said apparatus includes means for taking cephalometric radiographs, said means comprising: a head positioner; a collimator coupled to said X-ray source; and a hinged support bar having one end coupled to the upright member and its opposite end coupled to the head positioner, The subject being positioned within said head positioner, and the X-ray source being positioned a predetermined distance from the head positioner by the alignment means.
 15. A combination radiographic apparatus as defined in claim 2 wherein said X-ray source is a rotating anode tube.
 16. A combination radiographic apparatus as defined in claim 2 wherein said apparatus includes means for taking occlusal radiographs, said means comprising: a head positioner; a collimator coupled to said X-ray source; and a hinged support bar having one end thereof coupled to the upright member and its opposite end coupled to the head positioner, the X-ray source being aligned with the head positioner by the alignment means, the subject being positioned between the X-ray source and the head positioner.
 17. A combination radiographic apparatus for taking radiographs of a subjects head, teeth, jawbone and other parts of the subjects body, said apparatus comprising: a base member; an upright member coupled to the base member; an X-ray source; a film holder assembly coupled to the X-ray source and disposed opposite thereof enabling a subject to be positioned therebetween, said X-ray source and film holder assembly being coupled to the upright member; means for enabling the X-ray source and film holder assembly to rotate about the subject and defining a pivot point of rotation thereabout enabling the taking of panoramic radiographs; a guide support assembly slidably mounted to the upright member; a platform coupled to the guide support assembly; a pivot bracket support structure interposed between and coupled to the X-ray source and film holder assembly, and coupled to said platform; interchangeable means coupled to said bracket support structure enabling the pivot point of rotation of the X-ray source about a subject to be altered; and alignment means coupled to said pivot support structure and X-ray source enabling the X-ray source to freely rotate about its axis enabling the X-ray source to be aligned relative to the subject for taking intra-oral, occlusal and cephalometric radiographs.
 18. A combination radiographic apparatus as defined in claim 17 wherein said X-ray source is a rotating anode tube.
 19. A combination radiographic apparatus as defind in claim 18 wherein said means for rotating the X-ray source and the film holder assembly about a pivot point comprises: a motor assembly coupled to the pivot bracket support structure.
 20. A combination radiographic apparatus as defined in claim 19 wherein said means for rotating the X-ray source and the film holder assembly about a pivot point further includes: a first friction wheel engaging said platform being coupled to said motor assembly; a second friction wheel adjacent the film holder assembly, said second friction wheel engaging the platform and coupled to said film holder assembly so that as the motor assembly drives the first friction wheel about the platform motion is imparted to the second friction wheel; and means for disengaging the first friction wheel from the platform.
 21. A combination radiograph apparatus as defined in claim 20 wherein the means for interchanging the pivot point of rotation of the X-ray source and film holder assembly relative to the subject, comprises: a guide plate positioned between the platform and the pivot bracket support structure. cam follower means coupled to the pivot bracket support structure for matingly engaging said guide plate.
 22. A combination radiographic apparatus as described in claim 21 wherein said cam follower means comprises: a winged pivot bracket.
 23. A combination radiographic apparatus as defined in claim 22, said apparatus further comprising: pivot shifting means for shifting the upright member on the base member relative to a subject, enabling the subject to remain stationary while the pivot point is shifted relative tO said subject.
 24. A combination radiographic apparatus as defined in claim 23 wherein said pivot shifting means comprises: a guide shift bar having a first and second end; a lever arm having a first end and an opposite end; a slot positioned in said lever arm adjacent said opposite end thereof, wherein said first end of the guide shift bar is coupled to said upright member and the second end thereof is coupled to said slot, said lever arm being coupled to the base member by a support bracket.
 25. A combination radiographic apparatus as defined in claim 24 wherein said apparatus further comprises: a head positioning assembly coupled to the guide support assembly.
 26. A combination radiographic apparatus as defined in claim 25 wherein said head positioning assembly comprises: a forehead member coupled to the guide support assembly; an adjustable chin member; a lateral shift distance assembly; and a head mask coupled to said guide support assembly, said adjustable chin member and lateral shift distance assembly being coupled to said head mask. 